Swollen Lymph Nodes In Children: Causes And When To Worry

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Lymph nodes are kidney-shaped organs in the neck, underarms, groin, chest, and abdomen. They are a part of the immune system and play an important role in filtering the blood and killing bacteria and viruses. Swollen lymph nodes or lymphadenopathy is common in childhood and may occur due to bacterial or viral infections, such as colds, flu, or strep throat infection (1).

Read this post to learn about the causes, symptoms, complications, diagnosis, and treatment of swollen lymph nodes in children.

Causes Of Swollen Lymph Nodes In Children

The following are the common causes of lymphadenopathy in children (2)(3)(4)(5):

  • Respiratory infections
  • Viral throat infections
  • Bacterial throat infections, such as strep
  • Viral infections, such as flu, mononucleosis, and chickenpox
  • Tooth decay or abscess
  • Abrasions, burns, or insect bites
  • Scalp infections
  • Skin infections, such as eczema and impetigo
  • Mouth sores
  • Ear infections
  • Fungal infections
  • Autoimmune conditions
  • Some cancers, such as Hodgkin’s lymphoma
  • Juvenile arthritis and some other joint conditions

Symptoms Of Swollen Lymph Nodes In Children

The most common symptoms of swollen lymph nodes are (1)

  • Lumps in the affected lymph node areas, commonly the sides or back of the neck
  • Pain or soreness in the affected area
  • Redness or warmth in the affected area
  • Lymph nodes may be swollen several centimeters.

Depending on the underlying pathology, the following symptoms may also be seen:

  • Fever
  • Respiratory issues, such as sore throat, nasal congestion, and cough
  • Decreased appetite
  • Body pain
  • Headache
  • Fatigue
  • Weight loss
  • Rash

Complications Of Swollen Lymph Nodes In Children

Swollen lymph nodes are the body’s natural response to infections and some diseases. However, ignoring the condition may delay the treatment of a serious underlying disease or infection (1).

While swollen lymph nodes signify a problem and are not a problem themselves, the following complications may rarely occur (3).

  • May remain swollen or firm long after the infection has cleared up
  • May hamper the other functions of the body
  • Might break open and ooze pus

Signs You Need To See A Doctor

Contact your healthcare provider if you notice the following symptoms (1)(6):

  • The child develops a fever or a seizure accompanying it
  • Painful swollen lymph nodes
  • Lymph nodes that continue to grow or remain the same size beyond two weeks
  • A large lymph node that is firm to touch
  • Abnormal breathing sounds or the child complains of inability to breathe comfortably

Diagnosing Swollen Lymph Nodes In Children

The diagnosis of swollen lymph nodes begins with a physical examination of the enlarged lymph nodes’ size and location. Further, the doctor will ask the following (1)(3):

  • A detailed medical history of the child
  • For how many days the child has been exhibiting these symptoms
  • Whether the child has been around children with strep throat
  • Whether the child has consumed any unusual food or beverages, especially unpasteurized dairy products
  • Whether the child has been around a young cat as a cat’s scratch can cause a mild condition called cat scratch disease characterized by enlarged lymph nodes.

After examining these details, the doctor might refer the child to a specialist and prescribe some of these diagnostic tests:

  1. Lab tests: A complete blood count (CBC) might be performed to check the red and white blood cells and platelets. Urine tests and tests to rule out tuberculosis might be performed.
  1. Imaging tests: These include chest X-rays, CT scans, or MRIs to check for enlarged lymph nodes or other underlying conditions.
  1. Lymph node biopsy: A surgeon may perform a biopsy to test the samples of the enlarged lymph nodes for different causes of enlargement. The child may be further referred to hematologists and oncologists.

Treatment For Swollen Lymph Nodes In Children

In most cases, no intervention is needed for swollen lymph nodes. When required, the treatment depends on the underlying cause. It can be done at home for mild cases, while some children may need medications to manage it. Rarely, surgical intervention may be needed (3)(6).

1. Homecare

  • Ensure plenty of rest, ample hydration, and good nutrition.
  • Use cold or warm compresses to relieve pain or tenderness.
  • Give safe pain relief medications, such as acetaminophen, under the doctor’s advice. Aspirin should be avoided until the age of 20.

2. Medications

  • The child might need antibiotics for swelling caused by bacterial infections or anti-tuberculosis medicines for tuberculosis.
  • The doctor might prescribe further medication based on the underlying condition.

3. Surgery

  • When required, surgical intervention might be suggested to remove the swollen lymph node.
  • A pediatric surgeon might suggest incision and drainage for the swollen lymph nodes, depending on the cause.

Frequently Asked Questions

1. What is a concerning size for lymph nodes in children?

For children, lymph nodes of 1cm in the axilla, 2cm in the neck, and 1.5cm in the inguinal region are considered normal and do not need further investigations. However, lymph nodes that are 3cms or larger may be a cause for concern (7).

2. Is it normal to feel children’s lymph nodes in their necks?

Feeling some small, palpable lumps under your child’s skin is not unusual (8).

3. For how long can lymph nodes stay swollen in a child?

Lymph nodes remain swollen as long as the infection is active. It begins to return to normal size over a few weeks (9).

4. What do cancerous lymph nodes feel like?

Enlarged cancerous lymph nodes may feel like small, movable lumps under the skin (10). Lymph nodes larger than 3cms are usually associated with malignancy (7).

5. Can a swollen lymph node be harmless?

Lymph nodes may remain swollen for a few weeks after you have been cured of the illness. In most cases, they shrink to the original size on their own. However, if they do not do so in two weeks, seek medical attention (11).

Contact your child’s healthcare provider if you notice any swelling or lumps in the lymph node locations. Take pictures of the enlarged lymph nodes or measure them daily to track their growth. In many cases, symptoms subside with home care. However, it is recommended to take an expert opinion as early intervention can help the symptoms subside sooner.

Key Pointers

  • Bacterial and viral throat infections, respiratory infections, tooth decay, ear infections, and various autoimmune conditions can cause swollen lymph nodes in children.
  • Symptoms such as pain, feeling of lumps in the throat, and redness may indicate swollen lymph nodes.
  • Homecare measures such as warm or cold compresses and getting medications for underlying conditions help to improve swollen lymph nodes in children.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Lymphadenopathy in Children.
    https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02044
  2. Lymph Nodes – Swollen.
    https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/symptoms/lymph-nodes-swollen/
  3. Single Swollen Lymph Node in a Child (Lymphadenitis).
    https://mydoctor.kaiserpermanente.org/ncal/structured-content/Symptom_Single_Swollen_Lymph_Node_-_Pedi_ID.xml?co=%2Fregions%2Fncal
  4. Lymphadenopathy.
    https://www.chop.edu/conditions-diseases/lymphadenopathy
  5. Swollen lymph nodes.
    https://raisingchildren.net.au/guides/a-z-health-reference/swollen-lymph-nodes
  6. When Your Child Has Swollen Lymph Nodes.
    https://www.saintlukeskc.org/health-library/when-your-child-has-swollen-lymph-nodes
  7. Erman Ataş et al.; Evaluation of children with lymphadenopathy
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462268/#:~:text=In%20young%20children%2C%202%20cmrelated%20with%20malignancy%20(8)
  8. Swollen lymph nodes and other symptoms of lymphoma
    https://www.stanfordchildrens.org/en/topic/default?id=lymphadenopathy-90-P02044#:~:text=In%20children%2C%20it%20is%20normalan%20infection%20or%20other%20problem
  9. Swollen Glands
    https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Swollen-Glands.aspx#:~:text=Lymph%20node%20swelling%20usually%20disappearsfor%20more%20than%20five%20days
  10. Signs and Symptoms of Non-Hodgkin Lymphoma in Children
    https://www.cancer.org/cancer/childhood-non-hodgkin-lymphoma/detection-diagnosis-staging/signs-symptoms.html#:~:text=The%20enlarged%20nodes%20are%20oftenor%20a%20health%20care%20provider
  11. Swollen lymph nodes and other symptoms of lymphoma
    https://www.mdanderson.org/cancerwise/swollen-lymph-nodes-and-other-symptoms-of-lymphoma.h00-159464790.html
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Dr. Ritika Shah

Dr. Ritika Shah is a certified lactation counsellor from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate... more

Dr. Maria Katrina Florcruz

(MD, DPPS)
Dr. Maria Katrina Florcruz is a board-certified pediatrician and a Diplomate of the Philippine Pediatric Society. She is an active consultant at Diliman Doctors Hospital and a visiting consultant at The Medical City and Capitol Medical Center. Also an experienced health communications professional and content creator, Dr. Katrina was the content head for the medical media application Docquity, and a... more